The role of non-hormonal methods in treatment of urogenital menopausal syndrome: modern views

Abstract

The article is devoted to a review of the literature on the problem of overcoming the negative outcomes of the genitourinary syndrome of menopause (GSM). It is known that a woman is in menopause almost 30–40% of her life, and according to WHO, by 2030, 1.2 billion women will be in postmenopause. At the same time, there is an increase in life expectancy in developed countries, which also leads to an increase in the number of women with GSM. The article presents the pathogenetic mechanisms of the development of GSM, in particular, it is indicated that the occurrence and degree of manifestations of this pathology are proportional to the decrease in estrogens level and their metabolism in the organism. The prevalence of GSM symptoms among menopausal women has been shown in the article. The negative impact of the GSM outcomes on the quality of life of patients is described. Women who are sexually active during menopause are more likely to have the manifestations of this pathology and consult with the doctor, but sexually inactive women can also benefit from awareness of the manifestations and the treatment of GSM. Unlike vasomotor symptoms, which may become less pronounced over time, the manifestations of GSM progress if not to treat them, tend to more severe course, and almost never disappear spontaneously.Modern approaches to the treatment of this pathology are also given. In particular, the possibility of prescribing plant therapy as an alternative to menopausal hormone therapy is considered. Herbal medicines can be used for a long time and without health risks. A range of vaginal oils, vaginal moisturizers with hyaluronic acid, isoflavones (a medicine with fennel, chamomile and saffron) are commonly used to treat women with GSM.The article discusses the issues of recommendations for the prescription of herbal therapy, its advantages and features of use. The possibility of treating the symptoms of GSM for sexually active and inactive women with vaginal suppositories, which include hyaluronic acid (in the form of sodium salt), tocopherol acetate, Asian centella extract, chamomile flower extract, calendula officinalis flower extract, which have a moisturizing, regenerative effect, antiseptic, anti-inflammatory action for the rapid restoration of the vaginal mucosa. The effectiveness and safety of such therapy was established.